Nasal oral respiratory interface

ABSTRACT

The present invention provides an apparatus and a method for stabilizing at least one medical device such as a tracheal or gastric tube entering or covering at least one facial cavity such as the mouth and/or nose, taking advantage of a stabilization stent to secure to a patient&#39;s face the tracheal or gastric rube without the need to apply tape to the face, while maintaining visibility of tube markings, preventing kinking of the tube, and keeping the infant&#39;s face visible to parents and caregivers. In one form, the invention comprises a transverse stent comprising a superior border opposed to an inferior border, an inner surface and an outer surface. A first facial interface is attached to a first terminal end of the transverse stent, and positioned to mechanically clasp to a first side of a patient&#39;s face. A second facial interface is attached to a second terminal end of the transverse stent and positioned to mechanically clasp to a second side of a patient&#39;s face. A docking platform can be attached to the outer surface of the transverse stem to support a medical device.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of application Ser. No. 10/391,922,filed Mar. 18, 2003, which is a continuation of U.S. application Ser.No. 09/798,021 filed Mar. 1, 2001, now U.S. Pat. No. 6,561,192, whichclaims benefit of U.S. Provisional Application Nos. 60/186,859 filedMar. 3, 2000 and 60/201,935 filed May 5, 2000 respectively.

FIELD OF THE INVENTION

This invention relates generally to stabilization of medical devices,and more particularly to stabilization of devices that enter or coverthe nose and/or mouth. Although most useful in a neonatal intensive careunit (NICU) setting, the advantages of the present invention areapplicable to any patient age group or setting requiring suchstabilization.

BACKGROUND OF THE INVENTION

Infants requiring mechanical ventilation (assisted breathing) arecommonly treated by endotracheal intubation, wherein a flexible tube isinserted into the mouth, down the throat and through the lumen of thetrachea a predetermined distance, to deliver oxygen to the lungs. Inaddition, flexible feeding tubes may also be inserted through the noseor mouth, passing through the esophagus, and terminating in the stomachor lower intestinal tract.

Serious complications can result from accidental extubation(dislodgment) of these tubes, including acute hypoxia, bradycardia, andlong term laryngaltracheal damage from reintubation. Therefore, it iscritical to prevent accidental extubation. Traditionally, stabilizationto prevent accidental extubation has been accomplished by securing thetube to the face by wrapping an adhesive tape around the tube andadhering the tape ends to the patient's face.

However, adhesive tape stabilization methods provide poor fixation,allowing the tube to move when the skin is stretched. The tape obstructsthe face, has the potential to obstruct the nasal openings, and loosenswith time. Tape is difficult to remove and reapply when adjustments tothe tubes are required, often causing injuries to the skin by strippingaway the epidermis, especially in premature infants. Tape adhesionmethods have a further disadvantage, in that nasal and oral secretionsare absorbed by the tape, causing the tape to lose adhesion and loosen,while contaminating the tape with microbial organisms that couldcolonize the patient and gain direct access to the lung via theendotracheal tube and cause pneumonia.

Mechanical ventilation applies a pulling force on the tubing. As aresult of this pulling force, an improperly stabilized tube may causepain and discomfort if the tube slides up and down within the trachea,especially if it hits against the bifurcation of the trachea. Moreover,if the tube protruding outside the patient kinks, gas flow will beobstructed. Movement of the tube may cause it to extend and enter theright main bronchus, effectively removing the supply of oxygen to theleft lung, or it may extubate completely, removing the supply of oxygenentirely. Such movement of the endotracheal tube in a small prematureinfant is a major clinical problem. In these patients the trachea is soshort there may be only a few millimeters of discretionary tube movementbefore one of the above complications ensues.

Systems used to increase tube stabilization and limit tube movement haveincluded bite block and neck strap combinations to fix the tube inposition; a band extending across and adhered to the full width of theinfant's face, wherein the band contains tube-receiving receptacles atpredetermined locations; adhesive straps with a central opening over themouth and containing various tube locking means; and a flexible barplaced above the mouth and adhered to the infant's cheeks.

With the exception of the bar, these known stabilization attempts havecovered the patient's mouth and portions of the tube, making oralhygiene and tube visualization difficult. These devices further requirethe endotracheal tube be placed within the device prior to intubation,thereby blocking the clinician's visualization of the trachea andincreasing the difficulty of successfully placing the tube in itsdesired location, making the device potentially dangerous.

While known bar stabilization systems do not have the foregoingdisadvantages, these known bar systems rely solely on adhesion throughcheek pads which have no mechanical clasping. Therefore, the bar ispermitted to torque, allowing for excessive movement of the bar andexcessive movement of the attached tube. Additionally, the tube canrotate around the bar, allowing it to kink in the patient's larynx,restricting air flow, or placing extended tube pressure on the palate,causing interference with normal palatal development.

In an attempt to relieve palatal pressure, plates have been designed torest on the tube to prevent extended tube contact with the palate.However, these plates interfere with oral hygiene and are difficult andclumsy to place properly.

What is needed is a stabilization method that allows for securingtracheal and/or gastric tubes and other medical devices without applyingtape to the face, maintains visibility of tube markings, and keeps theinfant's face visible to parents and caregivers. It should also preventkinking of the tube and allow for attachment of additional anchoragewhen heavier loads (such as nasal continuous positive airway pressure(NCPAP) prongs) are applied, and prevent oral secretions from collectingand interfering with adhesion and/or causing infection.

By conceiving a method to stabilize medical devices that enter or coverthe nose and/or mouth using mechanical advantage along with adhesives,the present invention fulfills this need, and further provides relatedadvantages.

SUMMARY OF THE INVENTION

The present invention provides an apparatus and a method for stabilizingat least one medical device such as a tracheal or gastric tube enteringor covering at least one facial cavity such as the mouth and/or nose.The present invention takes advantage of a transverse stent containing adocking platform to secure patient tracheal and/or gastric tubes withoutthe need to apply tape to the face, while maintaining visibility of tubemarkings, preventing kinking of the tube, and keeping the infant's facevisible to parents and caregivers. The transverse stent is secured tothe patient's face using adhesive fixation and optional mechanicalclamping. The novel present invention also allows for attachment ofadditional anchorage when heavier loads need to be stabilized.

In one form, the invention comprises a transverse stent comprising asuperior border opposed to an inferior border, an inner surface and anouter surface. A first facial interface is attached to a first terminalend of the transverse stent, and positioned to adhesively adhere andmechanically clasp to a first side of a patient's face.

A second facial interface is attached to a second terminal end of thetransverse stent and positioned to adhesively adhere and mechanicallyclasp to a second side of a patient's face. A docking platform attachedto the outer surface of the transverse stent supports the medicaldevice.

In a different form, the invention adds gutters positioned on the innersurface of the respective first and second terminal end proximate to therespective first and second facial interface to channel oral fluids awayfrom the respective first and second facial interface.

One advantage of the present invention is that it provides an interfacefor the attachment of an assortment of medical devices that improvesupon the limitations of current attachment methods. In particular, itavoids the use of adhesive tape applied to the face, while providing amore stable and a secure attachment of these devices.

Another advantage of the present invention is that it provides a stabletracheal tube holder and tracheal tube stent, thereby maintaining theangle the tube enters the mouth, and preventing movement or kinking ofthe tracheal tube. In this manner, the tracheal tube will not impingeupon the infant's lip or palate, and therefore, will not negativelyimpact upon oral-facial growth and development.

Still another advantage of the present invention is that because theendotracheal tube is better stabilized, the risk of accidentalextubation is significantly reduced. This increase in stabilization alsoprevents tube movement during mechanical ventilation, thereby lesseningthe potential for patient discomfort, desaturation spells and laryngaltrauma.

Yet another advantage of the present invention is that the transversestent is stronger and more resistant to bending and buckling than knownstabilization systems. By providing the ability to easily add additionalanchorage, heavier medical devices, such as nasal CPAP cannula, can befully supported, thereby reducing patient discomfort associated withthose heavier devices.

Other features and advantages of the present invention will be apparentfrom the following more detailed description of the preferredembodiment, taken in conjunction with the accompanying figures whichillustrate, by way of example, the principles of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a frontal view of the present invention.

FIG. 2 is a representation of the invention stabilizing an endotrachealtube on an infant.

FIG. 3 is a view of the inner surface of the transverse stent.

FIGS. 4 a–4 c are a representation of a universal docking station.

FIG. 4 d is a representation of a nasal CPAP cannula.

FIG. 5 is a representation of an endotracheal tube and a nasalgastrictube supported concurrently.

FIG. 6 is a representation of a different embodiment depicting thehollow bore.

FIG. 7 is an oblique view of a representation of a different embodimentdepicting the clamp.

FIG. 8 is a frontal view of the embodiment of FIG. 7.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The present invention sets forth a method and an apparatus forstabilizing at least one medical device entering at least one facialcavity. Such medical devices may include, for example, endotrachealtubes, nasotracheal tubes, nasalgastric tubes, naso or orojejunal tubes,nasal thermistors, nasal pneumotachometers, nasal capnographs, nasalmasks, oxygen delivery tubing and nasal CPAP delivery systems, althoughthe present invention will stabilize any device entering or covering themouth or nose. For the purposes of this disclosure, the term “tube” ismeant to include all such medical devices entering the mouth or nose,and the present invention is not limited to stabilizing medical devicestubular in shape. Likewise, it should be understood that oral insertion,nasal insertion or both simultaneously will be stabilized equally well.

As shown in FIG. 1, the present invention comprises a first 2 and second4 facial interface positioned on opposite terminal ends of a transversestent 6 to mechanically and adhesively clasp both sides of a patient'sface 29 (FIG. 2). A docking platform 8 is attached to the transversestent 6 to support at least one medical device 22 (FIG. 2).

The transverse stent 6 is generally arch shaped so as to follow thecontours of the patient's face 29, and of a length sufficient to permitthe first 2 and second 4 facial interface to rest on the right and leftsides of a patient's face 29, for example, on the right and left cheek.While the transverse stent 6 may take any shape in cross-section, forexample, triangular, round or oval, in its preferred form, thetransverse stent 6 is square or rectangular in cross-section, having asuperior border 10 opposed to an inferior border 12, an inner surface 30(FIG. 3) towards the patient's face 29 and an outer surface 14. Thesedefined borders and surfaces allow for more precise placement of thedocking platform 8 and optional mechanical clasps (discussed below). Ina preferred embodiment, the transverse stent 6 is about 6 mm in widthand about 2.5 mm deep. It will be understood, however, that both thewidth and depth will depend on the material used and the relative sizeof the patient.

When the first 2 and second 4 facial interfaces are in proper positionon the patient's face 29, the transverse stent 6 should remain about 1mm to about 3 mm above the maxillary, or upper, lip 24 (FIG. 2), so asto not interfere with or traumatize the lip 24 or trap debris betweenthe transverse stent 6 and maxillary lip 24, and allow access for properhygiene. The transverse stent 6 should be sufficiently rigid enough tosupport the attached medical device or devices 22, yet have the abilityto yield slightly in a manner that will allow the first 2 and second 4facial interfaces to approximate (move medially) if the patient were tolay with the head on one or the other side. The ability of thetransverse stent to yield slightly in all directions helps to dissipateany displacement force applied to the medical device 22 or to thetransverse stent 6, rather than directing the entire displacing force tothe first 2 and second 4 facial interface.

While metals such as, for example, stainless steel, titanium, Ni—Cr andother alloys may be used, ideally the transverse stent 6 should behypoallergenic and, optionally, clear so as to not obstructvisualization of the patient's face 29 or of the medical device 22 orany markings contained within or on the medical device 22. Materialsuseful for this purpose would include, for example, polymers such as,for example, polystyrene, polyurethane, polycarbonate, fiberglass andthe like that preferably are transparent or translucent whenpolymerized.

The transverse stent 6 and/or facial interface 2, 4 may be manufacturedinto a variety of shapes and sizes that allow the clinician to choosethe ideal transverse stent 6 and/or facial interface 2, 4 for theindividual patient. Alternatively, at least a portion of the apparatusmay be fabricated from a material that is pliable until activated,whereupon, once activated, the material sets to aclinician-predetermined shape. In this manner, the transverse stent 6and/or facial interface 2, 4 in its pliable form may be custom molded tothe patient's face 29 and then activated to take a permanent set.

This activation may take the form of, for example, a light-activatedpolymer in which a predetermined wavelength of a light is applied to thematerial to effect polymerization and, hence, the permanent set, or itmay take the form of mixing two materials together to initiate anauto-polymerization, or the polymerization may be heat activated.Another alternative to establishing proper length of the transversestent 6 is to cut the transverse stent 6 to its proper length prior toattachment, using known adhesive methods, of the first 2 and second 4facial interface. Still another alternative (not shown) to establishinga clinician-predetermined length is for a first half of the transversestent to be slidably contained, for example, using a tongue and groove,within, in front, or behind a second half of the transverse stent. Oncethe halves are slidably moved to establish the predetermined length, thehalves are fixed in the predetermined length, for example, by crimping ametal band around the overlapping halves, or by stapling the halveswithin the overlapping portion.

The first 2 and second 4 facial interface are mirror images of oneanother and in the interest of brevity will not be described separately.It is to be understood that the second facial interface 4 mirrors thefirst facial interface 2 description which follows.

The facial interface 2 may be integrally fabricated as part of thetransverse stent 6, or it may be separately fabricated and subsequentlyadhered, using known adhesives techniques, to the transverse stent 6. Itmay take any shape that provides a surface area of sufficient size toeffectuate adequate adhesion to the patient's face 29 once adhesive isapplied. The facial interface 2 may be substantially flat or it may besubstantially contoured to follow the contours of a patient's face 29.It must be stiff enough to resist deformation when a displacement forceis applied to the transverse stent 6.

Ideally, the surface area should be minimized so as to cover the leastamount of the patient's face possible yet maintain adequate resistanceto displacement forces. In a preferred embodiment, the facial interface2 is generally “Y” in shape. While the advantages of the transversestent 6 are obtained when the facial interface 2 is adhesively adheredto the patient's face 29 by a substantially flat facial interface 2,ideally, the facial interface 2 should mechanically clasp, as well asadhesively adhere to the patient's face 29. For the purposes of thisdisclosure, the term “mechanically clasp” is meant to include resistanceto movement through primarily physical forces, for example, frictionalforces; and the term “adhesively adhere” is meant to include the bondingof two substances together by interfacial forces, for example, valenceforces, interlocking action, or both. In a preferred embodiment, thefacial interface 2 is fabricated from the same material as thetransverse stent 6, such material having plastic properties that allowcontouring of the facial interface 2 to the patient's face 29. It is thecontour which provides the mechanical clasping. Ideally, the facialinterface 2 is positioned such that at least a portion of its inferiorborder 16, which is distal to the inferior border 12 of stent 6, iscontoured to overlie at least a portion of an inferior border of apatient's mandible 23. For the purposes of this invention, the term“overlie an inferior border of a patient's mandible” means resting on afacial skin surface which covers the inferior border of the mandible.

For example, to achieve this mechanical clasping, the inferior border 16of the facial interface 2 is rotated medially about 5 degrees to about35 degrees around the line 18 longitudinally bisecting the transversestent 6. This rotation of the facial interface 2 inferior border 16 maybe pre-molded into the apparatus, or alternatively, if the facialinterface 2 is fabricated separately and subsequently adhered to thetransverse stent 6, the appropriate rotation is maintained whileadhering the facial interface 2 to the transverse stent 6. Themechanical clasping, acting synergistically with an adhesive applied tothe facial interface 2, provides increased resistance to transversestent 6 displacement forces.

The adhesive may be pre-applied to the facial interface 2 and coveredwith a protective, removable backing (not shown), for example,polyurethane, cellophane or other backing material, as is well known inthe art, which is removed prior to placement, or the adhesive may beapplied directly to the patient's face 29 prior to seating the facialinterface 2. When the facial interface 2 is seated, the adhesive layershould extend beyond the edge of the interface 2 to spread and reducethe adhesive forces on the skin. The adhesive is, for example, anyprotective adhesive that is nonirritating and, optionally, transparentto fragile newborn facial tissue, of sufficient viscosity to allow forcontrolled placement and spreading, allows for easy removal of excessadhesive, and permits for easy removal of the facial interface 2(preferably with water) when desired, without damaging the underlyingtissue. Examples of such adhesives are water-based adhesives such ashydrogel adhesives sold through Ludlow, and pectin based adhesives, forexample, Duoderm Extrathin, manufactured by Convatec, Inc., and Comfeel,manufactured by Coloplast Company.

The medical device 22, for example, an endotracheal tube, is fixed, forexample, taped, to a docking platform 8. In a preferred embodiment, thedocking platform 8 is a cantilevered finger 20, molded as part of thetransverse stent 6, projecting from the inferior border 12 of thetransverse stent 6 at a predetermined angle, for example, about 65degrees to about 115 degrees. preferably about 95 degrees, although itshould be understood that any predetermined angle allowing for fixationof the medical device 22 is acceptable. Optionally, the most distalportion 19 of the cantilevered finger 20, about 35 mm in lengths issubstantially flexible while the medial portion 17, about 15 mm inlengthy is substantially rigid. In this manner, some or all of a medicaldevice displacement force will be dissipated through the flexibleportion 19 before reaching the transverse stent 6. At least one optionalchannel 15 may be molded into at least one surface, preferably the topsurface, of the cantilevered finger 20 for receiving a medical device22, for example, a tube. Affixing a tube to the cantilevered finger 20prevents the tube from kinking.

Optionally, the cantilevered finger 20 may extend from the superiorborder 16 of the transverse stent 6 for support of nasal tubes (notshown). The cantilevered finger 20 may be molded on the top, bottom orboth surfaces for receiving and fixing a medical device 22, for example,an endotracheal tube or CPAP prongs.

It should be understood that the docking platform 8 may extend from thetransverse stent at any angle required to make the docking platform 8functional. This may range from a negative angle, as might be required,for example, for medical devices entering the nose, to an angle of about180 degrees.

The docking platform 8 may be located anywhere along the length of thetransverse stent 6 to meet specific clinical indications. Likewise, thedocking platform 8 maw project from the outer surface 14 at the superiorborder 10, the inferior border 12, or anywhere within the body of thetransverse stent 6, or may span the transverse stent 6 from the superiorborder 10 to the inferior border 12, as clinically indicated.

In another embodiment of the device shown in FIGS. 4( a)–(d), auniversal docking station 41 is fabricated into outer surface 14 at forexample, as shown in FIG. 4( a), the center of the transverse stent 6.The universal docking station 41 is, for example, a recess 40 toremovably receive a tongue 48 having a projection, or other form ofdocking design that would permit the removable attachment of medicaldevices such as, for example, a CPAP canella (e.g. FIGS. 4 b–4 c) orother tubes (e.g. see body shown in FIG. 4 d having tube connections andfluid bores there through), using, for example, a snap fit arrangement(described below).

Alternatively, a docking platform 8 may be removably mounted to theuniversal docking station 41 using, for example, such as the snap fitarrangement or tongue and groove shown in FIGS. 4 a–d. The recess orgroove 40 molded within the universal docking station has slots 42 tomechanically engage docking platform tabs 44 extending from the dockingplatform tongue (here CPAP cannula 48). The tabs 44 are urged, such asby spring-loading, so that they may be disengaged for easy removal ofthe docking platform 8 or other member. The transverse stent 6 mayinclude more than one universal docking station 41 to provideflexibility positioning the docking platform 8 or other member on thetransverse stent 6.

A heavier medical device 22 attached to the docking platform 8 mayrequire additional stabilization anchorage. As shown in FIGS. 1 and 7,optional anchorage attachment 13 is positioned on the outer surface 14of the apparatus for receiving an attachment point of at least oneadditional anchorage such as, for example, a head strap, chin strap orboth (not shown). The anchorage attachment 13 may be any attachment thatallows for easy attachment and removal of the additional anchorage, suchas, for example, a button, hook, hook and loop, slot, tab, combinationsthereof and the like.

In still another embodiment, shown in FIG. 3, to prevent oral secretionsfrom interacting with and interfering with the adhesive bond, and/orcollecting and harboring bacteria, gutters 32 are fabricated into theinner surface 30 of the terminal ends 36 of the transverse stent 6,proximate to the facial interface 2, 4, to channel oral fluids away fromthe facial interface 2,4. These gutters 32 may take the form of, forexample, a channel or groove molded into the inner surface 30 of thetransverse stent 6 traversing the stent 6 from the superior border 10 tothe inferior border 12. An optional raised lip 34 running parallel anddistal to the gutter 32 provides further protection from oral fluidcontamination of the adhesive.

Returning to FIG. 1, optionally, the transverse stent 6 has one or moremechanical retaining points, such as clips or clasps 60 or channel 61,to removably receive a portion of at least one medical device 22, forexample a portion of a tube. The mechanical retaining points may bemechanically, chemically or metallurgically attached to the outersurface 14 of the transverse stent 6 using known methods, such aswelding, bolting or screwing, or they may be integrally molded as partof the transverse stent outer surface 14. The at least one clip 60and/or channel 61 are appropriately sized to mechanically retain a tubeto the transverse stent 6, as shown in FIG. 5. The mechanical retainingpoints, such as the clasps 60 and channel 61 are particularly useful in,for example, retaining a nasalgastric tube 64 used in combination withan endotracheal tube 66.

In yet another embodiment, shown in FIG. 6, a hollow bore 70 ofpredetermined diameter is fabricated within the transverse stent 6 totransport a supply of gas, for example, a medical gas (not shown). Thebore 70 has a first opening 72 at the distal end of the apparatus toreceive the medical gas, and a second opening 76 at the docking station8 to deliver the medical gas. The bore 70 runs substantiallylongitudinally through the interior of the transverse stent 6.

In still another embodiment, shown in FIGS. 7 and 8, a groove 80fabricated, for example, in the center of the superior border 10 of thetransverse stent 6, further supports tubes that enter the nose, forexample, feeding tubes, CPAP prongs and oxygen tubes. A clamp 82 mayoptionally be molded to the bottom surface of the cantilevered finger20. The clamp 82 is fabricated to be urged, such as by spring loading tosurround a medical device 22, for example, an endotracheal tube. Theclamp 82 only partially surrounds the tube, allowing a portion of theexposed tube to adhere to adhesive tape (not shown).

The clamp 82 can accommodate tubes of varying sizes. In a preferredembodiment, the clamp 82 can accommodate tubes with internal diametersof about 2.5 mm to about 3.5 mm. The clamp must be of sufficient lengthto supportively engage the tube, preferably about half the length of thesubstantially rigid portion of the cantilevered finger 20. In apreferred embodiment, this length is about 6.5 mm to about 8.5 mm, mostpreferably about 7.5 mm. Optionally, the tube is further supported tothe cantilevered finger 20 with adhesive tape covering, for example, thefull length of the cantilevered finger 20, including the clamp 82. Whendesirable to remove the clamp, such as when the patient is nasallyintubated, the clamp is removed by, for example, cutting, twisting orgrinding. Optionally, the clamp may be fabricated to removably attach tothe cantilevered finger 20, for example, as in the manner describedabove with the universal docking station 41.

In use, the present invention would operate as follows: After clinicallydetermining the appropriate size and shape of the transverse stent 6 andthe amount of mechanical clasping needed, a properly fitted stabilizingapparatus is either selected from stock or custom fabricated bedside.

After the medical device 22 has been delivered to the patient, forexample, after the endotracheal tube has been inserted, adhesive isapplied to the predetermined area of the face 29, or, alternatively, ifthe facial interface 2, 4 is preloaded with adhesive, the protectivebacking, for example, an adhesive release liner, is removed. The facialinterface 2, 4 is placed on the face 29 and adhered to position thetransverse stent 6 above the patient's maxillary lip 24 in thepredetermined position.

Once the adhesive has set, the medical device 22 is removably fixed tothe docking platform 8, for example, by taping or clamping. In thepreferred embodiment, the endotracheal tube 66 is taped to thecantilevered finger 20. If, for example, a nasalgastric tube 64 is alsoin use, it is removably affixed to the docking platform 8, oralternatively, removably fixed by the optional mechanical clasps 60 onthe outer surface 14 of the transverse stent 6. If additional anchorageis required, head or chin straps are removably affixed to the anchorageattachments 13.

With the present invention in place, the oral cavity presents easyaccess for support staff to maintain proper hygiene. Markings on thetubes, for example indicators to insure proper tube insertion, areclearly visible. Once stabilized, tubes maintain their originalposition, avoiding the risk of accidental extubation, laryngal trauma,or adverse influence on oral-facial growth and development.

Should emergency removal of the tubes be required, the tape affixing thetube to the docking platform may be quickly and easily cut, oralternatively, the transverse stent may be easily and quickly cut fromthe facial interface, allowing the tube and transverse stent to beremoved simultaneously.

The present invention also comprises a system for stabilizing at leastone medical device entering at least one facial cavity formed by theabove-described method.

Although the present invention has been described in connection withspecific examples and embodiments, those skilled in the art willrecognize that the present invention is capable of other variations andmodifications within its scope. These examples and embodiments areintended as typical of, rather than in any way limiting on, the scope ofthe present invention as presented in the appended claims.

1. An apparatus for stabilizing, supporting, or securing items on apatient's head comprising: a member having a superior border and aninferior border, the member further including an inner surface and anouter surface, the member further including at least one facialinterface; and a projection extending from the member wherein theprojection extends towards the inferior border at an angle relative tothe member, wherein the projection comprises a flexible portion so thatthe projection may flex when exposed to a load to form a substantiallyarcuate shape.
 2. The apparatus as recited in claim 1, wherein the angleof the projection relative to the member is between approximately 65degrees and 115 degrees as measured from the superior border towards theinferior border.
 3. The apparatus as recited in claim 2, wherein theangle of the projection relative to the member is approximately 95degrees as measured from the superior border towards the inferiorborder.
 4. The apparatus as recited in claim 2, wherein the projectionis substantially linear.
 5. The apparatus as recited in claim 1, whereinthe projection is substantially arcuate.
 6. The apparatus as recited inclaim 1, wherein the projection comprises a channel sized and shaped toreceive a medical device.
 7. The apparatus as recited in claim 1,wherein the apparatus is constructed from a semi-translucent material.8. An apparatus for stabilizing, supporting, or securing items on apatient's head comprising: a member having a superior border and aninferior border, the member further including an inner surface and anouter surface, the member further including at least one facialinterface; and a means for securing at least one tube substantiallyadjacent the member, wherein the means for securing comprises a channelformed in the member sized and shaped to receive a tube.
 9. Theapparatus as recited in claim 8, wherein the means for securingcomprises at least one clip sized and shaped to receive the tube. 10.The apparatus as recited in claim 8, wherein the apparatus isconstructed from a semi-translucent material.
 11. The apparatus asrecited in claim 8, wherein the apparatus further comprises an adhesiveapplied to the facial interface.
 12. An apparatus for stabilizing,supporting, or securing items on a patient's head comprising: a memberhaving a superior border and an inferior border, the member furtherincluding an inner surface and an outer surface, the member furtherincluding at least one facial interface; a means for holding a medicaldevice, wherein the means for holding the medical device is a removabledocking platform; and a means for securing the holding means to themember, wherein the securing means includes a recess sized and shaped toreceive at least a portion of the holding means.
 13. The apparatus asrecited in claim 12, wherein the removable docking platform comprises acannula.
 14. The apparatus as recited in claim 12, wherein the removabledocking platform comprises a projection having a hole for holding amedical device.
 15. The apparatus as recited in claim 12, wherein theremovable docking platform further comprises a tab, and wherein theseeming means further comprises a slot whereby the removable dockingplatform is secured by fitting the tab into the slot.
 16. The apparatusas recited in claim 12, wherein the apparatus is constructed from asemi-translucent material.